Self-traumatizing disorders, such as self-inflicted barbering or hair removal and abrasions or ulcerations of a body part,
can occasionally start as a behavioral pathology. When presented with an apparently pruritic patient—or any patient that has
caused damage to itself with its teeth, tongue, claws or even an external object—perform a thorough history and medical workup
to search for the underlying cause. Endocrine, neurologic, musculoskeletal, infectious, immune-mediated, neoplastic, inflammatory,
traumatic, dermatologic and behavioral causes can all play a part in an itching, scratching and chewing pet.
Morris, a 5-year-old neutered male cat, is brought in for evaluation because of generalized hair loss and excessive grooming
(Photo 1). He began grooming more frequently during the past six months, primarily at night. The hair loss is mostly on the
inside forelimbs and ventral abdomen. Morris is an indoor cat and the only cat in the household; there has been no change
in his environment. He is up-to-date on vaccinations, is eating and drinking normally and has no history of vomiting, diarrhea,
coughing, sneezing or increased thirst or urination. He has received the same adult-food diet for the past five years.
Photo 1: Morris is experiencing generalized hair loss and excessive grooming.
Physical examination reveals extensive regions of alopecia without redness, rash or skin thickening. The medical team obtains
a standard dermatologic database that includes a skin scrape, skin cytology and fungal culture. The skin scrape and cytology
reveal no abnormalities. An oral antihistamine for pruritus and topical antifungal medication for potential dermatophytosis
After two weeks, the dermatophyte culture results remain negative, and the owner reports that topical and systemic medications
have not changed Morris' signs. The results of a complete blood count, serum chemistry profile, urinalysis and thyroid profile
After using a thorough protocol to help identify patients with allergic and endocrine-type skin disorders, the medical team
determines that Morris does not appear to be afflicted by either of these conditions. They now must look to other possible
causes of his chronic behavior.
Pruritic or other self-mutilatory disorders seen in the behavioral specialty can include compulsive disorders, displacement
activities and stereotypic, attention-seeking and other anxiety-related behaviors. These are classified as primary behavioral
disorders, with any skin manifestations occurring secondary to the self-induced trauma.